Hastings, Charles John Colwell Orr, obstetrician, medical officer of health (b in Markham Township, Canada W 23 Aug 1858; d at Toronto 17 Jan 1931). Educated at Victoria Coll Medical School in Toronto with postgraduate training in Great Britain, Hastings was one of the first full-time obstetricians to practise in Toronto. As Toronto's MOH 1910-29, he purified the water supply and established an internationally recognized public-health nursing system. He was a leading pioneer of health education programs, medical and dental inspection in public schools, and neighbourhood baby clinics in Canada. These innovations lowered Toronto's death rate from communicable diseases (from 15.3 per 1000 in 1909 to 10.3 per 1000 in 1925) and made the city a cleaner and healthier place to live. Hastings's accomplishments were recognized with his election as president of the Canadian Public Health Assn in 1916 and the American Public Health Assn in 1918. Through his efforts, Toronto's health department became internationally renowned for its achievements in preventive medicine.

Toronto's 100-year battle over "pure milk" has its roots in the evolving priorities of urban centres
Nov 23, 2008 04:30 AM
Christine Sismondo
SPECIAL TO THE STAR

A little more than a hundred years ago, Mayor Joseph Oliver was sworn into office at Toronto's Old City Hall, vowing to clean up this burg.

This was no metaphorical sweep of the broom Oliver was talking about. He meant it literally. His Jan. 13, 1908, inaugural address made it clear what three of his top priorities were: the construction of a trunk sewer, clean water and pure milk.

Oliver's address was an articulation of the new priorities of urban centres in the early 20th century. And Toronto, in part because of activist journalism and the philanthropy of newsmen such as Joseph Atkinson and John Ross Robertson, was to become a leader in making those public-health ideals a reality.

It wasn't going to happen all at once, though. While Oliver had said that the "establishment of a milk standard of the highest possible percentage (was) of the utmost importance," the best way to do that was going to be the subject of a debate that would rage for some time ? arguably to this day.

To some, the answer was to test milk for a minimum three per cent butterfat content, to ensure there was no adulteration. It was common practice to dilute milk with water, skim fat off the milk, and to mask spoiled milk by adding molasses or even chalk. Even this proposal to test was surprisingly controversial. The Municipal Committee of the Legislature killed a "pure milk bill" on March 27, 1908, on the grounds that it might discriminate against some Holsteins who, it seems, had unusually lean milk.
Others were proponents of certification, basically a regulation of the dairy industry by ensuring that barns and trucks were clean, equipment and bottles sterilized, and the product kept at a cool temperature across the supply chain. This solution was not terribly contentious, and the municipal Pure Milk Commission, established in 1908, advocated the adoption of these measures. However, putting the infrastructure in place for certification was going to take time.

In the meantime, Dr. Charles J. Hastings, who would later become Toronto's Medical Officer of Health, had the bright idea to pasteurize all milk, certified or not. His 1907 visit to the pioneering Straus Milk laboratory in New York, and his understanding of Toronto public health, convinced him that unpasteurized milk was the main culprit in the spread of bovine tuberculosis and typhoid fever, and responsible for the death of 400 Toronto children per year.
To make his point, Hastings began testing milk samples from various Toronto hospitals, and reported high levels of bacteria across the board. One hospital's milk (Hastings refrained from mentioning the facility's name) apparently had "no less than eight million bacteria per cubic centimetre." (A roughly contemporaneous study put the highest acceptable level at 10,000 bacteria per cubic centimetre.)

The picture on this page appears to show filters through which milk has been poured, capturing the dirt found in one pint.

These samples are from the City of Toronto Archives' Public Health Series, a collection of photos documenting the gains made in controlling disease through vaccinations, cleaner water, better sewage treatment and, of course, pure milk
A current Toronto Archives exhibit, which draws from that collection, is called An Infectious Idea: 125 Years of Public Health in Toronto (and runs through 2009) and contains similar images. This photograph was taken Sept. 23, 1921.

Hastings' hospital revelation, reported in the Sept. 14, 1908, Toronto Daily Star, didn't seem to faze Medical Health Officer Dr. Charles Sheard, who maintained that pasteurization "was not worth it," given the cost.
Sheard was not Hastings' only opponent in the medical community. Many were dismayed that they might lose the right to give patients raw milk, which some doctors reported was easier for patients needing nourishment to digest than pasteurized. At a public debate with Hastings, Sheard advocated that, instead of pasteurizing milk, they should concentrate on improving the standards of its production.

Hastings was quick to point out that this was a false dilemma ? there was, from his point of view, no reason not to do both ? and proceeded to skewer his opponent's faulty logic. In the Star, the subhead for the report on the debate read: "A Roast for Sheard."

But there were valid arguments against pasteurization, too. As mentioned, doctors reported that patients had difficulties digesting pasteurized milk. And pasteurization threatened to drive up the cost of milk by 60 per cent, a significant increase for a household staple.

That's probably when it occurred to philanthropists such as Atkinson, legendary publisher of the Star, that the problem wasn't so much pasteurization, or even bacteria, but poverty. After all, "pure" milk had been available at the City Dairy for years, but the poor couldn't afford to buy it.

The first philanthropic outfit to address this disparity was a clinic at 88 Edward St. established in 1908 by the Toronto chapter of the Pure Milk League. There, half-pint bottles of certified milk could be purchased for two cents (roughly the same price as milk elsewhere). Those who couldn't afford that price were given the milk for free.
That same year, around the corner at the Hospital for Sick Children, Robertson, founder of the rival Toronto Telegram, funded the installation of the first milk-pasteurization plant in a Toronto hospital.

Not to be outdone, Atkinson stepped up his coverage of the Pure Milk campaign and started up the Infant's Pure Milk Fund. It was regularly covered in the Daily Star, including solicitations, shout-outs to donors, and funding totals, which were printed on the front page of the daily at least twice a week.

In 1910, the Daily Star reported the establishment of a "pure milk depot" run by the Canadian Household Economic Association at the Jewish Free Dispensary on Elizabeth St. and the imminent opening of two more. Atkinson's fundraising had been crucial to the establishment of all three.

Just as important was the change in public opinion that Atkinson's support had helped to effect. Hastings would win his seven-year war, and it would become mandatory that all milk in Toronto be pasteurized but for two certified raw-milk dispensaries.

Yet the medical community remained divided, as some experts are now. On March 23, 1915, amidst headlines such as "Shells dropped from the clouds like fireworks" and "Narrows' Forts are still intact at Dardanelles," there was a Star news story about opposition from Dr. J.B. Fraser, who lamented the lack of raw milk for his sick patients.
Said Fraser: "Instead of giving us the standard of butterfat, we get the standard of bugs."

These arguments, however, held little weight in the court of public opinion and even less in the mayor's office, which was by then held by Tommy Church. As soon as Mayor Church had been reassured that Louis Pasteur was not German but French, he sided with Hastings ? and his standard of bugs.

Seven years and two successors after Mayor Joseph Oliver expressed it, his vision of public health in Toronto was becoming a reality.

Slums, what slums? Poverty seemed part of the natural order a century ago, when a prominent city official made graphic his call for civic action. Some of those images are in a remarkable new book of Toronto's official photography that mirrors our attitudes and ambitions since 1856.

Kenneth Kidd
Feature Writer

It's not just that they don't smile. Scarcely anyone does in old photographs.

What haunts is that look of dark cynicism in the eyes of even the smallest children, as if they are merely dwarf versions of the weary and grime-covered adults around them, slum-dwellers all, in the years just before World War I.

This is a Toronto we often pretend didn't exist, a function of the long-standing national conceit that the country is somehow new, clean and innocent, virtually Pearsonian in its origins.

When Arthur Goss took his slum pictures, hundreds of them, he laboured under no such illusions. As the city's staff photographer, he'd been commissioned by the crusading Charles Hastings, the city's medical health officer. A small sample of Goss's slum portraits appears in Toronto's Visual Legacy, recently published to celebrate official city photography since 1856.

The slums were spread all over downtown Toronto, extending into what is now Nathan Phillips Square, in the shadows of Old City Hall. The juxtaposition of wealth and poverty, ceremony and squalor, is telling. It's not as if city elders were ignorant of the existence or extent of the slums.

The difficulty was getting them to confront such social conditions, especially since many of those civic leaders would have considered such poverty to be simply part of the natural order, as it always had been.

If, as historians often argue, the social and political mores of the 19th century really extended until World War I, then this was still a Dickensian battle.

Friedrich Engels, for instance, famously set out to record working-class conditions in Britain. He found that a fifth of Liverpool's population, more than 45,000 people, were crowded into fewer than 8,000 "damp, badly ventilated cellar dwellings."

This was in 1844, and it would soon move him to join Karl Marx in writing the Manifesto of the Communist Party, a passage from which reads: "All that is solid melts into air, all that is holy is profaned, and man is at last compelled to face with sober senses, his real conditions of life."

What's so astonishing is that nearly identical passages grace myriad books and reports in subsequent decades, up to and including the special report that Hastings would pen in 1911. His effort approvingly quotes Sydney Webb, a Fabian socialist prominent in Britain, describing "the soul-destroying conditions of the one-roomed dwellings which make decent life impossible, involves the absence of proper light, or privacy, leading to physical and mental suffering and inefficiency."

Hastings's own prose is equally direct about conditions in Toronto slums.

"The teachings and examples of drunkards, thieves, filthy personalities, gamblers and prostitutes in large city slums are rarely ineffective," he writes. "A child born and reared amid such surroundings has about the same chance of escaping a life of shame or crime as an unvaccinated baby confined in a pest-house would have of escaping smallpox."

In making the case for reform, Hastings is deft and studied, sprinkling some of the Goss portraits throughout his text. Such use of photography wasn't new. In New York, Jacob Riis had similarly photographed and written about slums for his 1890 book, How the Other Half Lives.

But Riis was a former crime reporter turned social activist. This was Toronto's chief medical health officer commissioning the city's own photographer for an official report. It was an inside job.

But Hastings still knew what he was up against, which is why he seems to appeal to different constituencies, yet without unduly offending the prejudices and political concerns of the day.

He sets out, as Engels did nearly 70 years earlier, to quantify, quantify, quantify. The Victorians were enthralled with taxonomy, data, and a scientific approach. So is Hastings. Having divided the city into many districts, he then provides arresting anecdotes and statistical summaries from most of them.

There's the house where 19 men sleep in three rooms, or the backyard slum that's reached by entering "a curious tunnellike passage from the street, down a dark and precipitous stairway, and up again into a back yard, where the house was found thus concealed."

Tellingly, Hastings goes on to enumerate the slum-dwellers of one district by their "various foreign nationalities," 14 categories in all, from "Hebrew" (1,267 people) to "Finlanders" (2). This also allows him to note, in that day's common condescension, that "their ideas of sanitation are not ours" and to take aim at their landlords.

"The foreign element, however, is responsible for these exorbitant rents, that is, those of them who have been a few years in the country and have acquired property in those districts."

In other words, good Torontonians, we're not really blaming you for these conditions, just asking you to fulfill your Kiplingesque duty to help out these inferior foreigners. Not doing so is where the shame comes in.

Hastings notes how, in three core districts, nearly 19,000 people share fewer than 4,500 privies, half of them outside. He calls that "a relic of barbarism which should no longer be tolerated."

And later: "What we read of with disgust as having happened in the cities of Europe in the Middle Ages, happens now in Toronto before our very eyes.

"The people of Toronto, or foreigners coming into Toronto, should not be permitted to be forced into such conditions."

There is even an appeal to military sensibilities, at a time when Torontonians still had keen memories of the Boer War and Britain and Germany were locked in a long-running arms race. So Hastings dutifully notes how, in poor, working-class Manchester, home to similar slums, 11,000 men had tried to enlist for the Boer War.

Of those, 8,000 were rejected outright, 2,000 managed to slip into the militia, while only 1,000 were considered to be in good enough physical shape to join the regular army. Having stated the numbers, Hastings lets the argument sit there, ungilded.

"It is of great importance that the poorer classes of this Dominion should be provided with respectable housing accommodation in place of the disgusting hovels in which so many of them now exist."

Hastings, who died in 1931, didn't live to see his dream of government-sponsored "garden cities" springing up on the outskirts of Toronto to house the poor.

But his report did persuade the city to start installing indoor plumbing in the houses of the poor, billing the landlords for the cost. And the city would soon be building massive trunk sewers in earnest, something Goss would also be there to record.